Friday, May 14, 2021

How Exercise May Help Us Flourish

Physical activity can promote a sense of purpose in life, creating a virtuous cycle that keeps you moving.

Our exercise habits may influence our sense of purpose in life and our sense of purpose may affect how much we exercise, according to an interesting new study of the reciprocal effects of feeling your life has meaning and being often in motion. 

The study, which involved more than 18,000 middle-aged and older men and women, found that those with the most stalwart sense of purpose at the start were the most likely to become active over time, and vice versa.The findings underscore how braided the relationship between physical activity and psychological well-being can be, and how the effects often run both ways.Science already offers plenty of evidence that being active bolsters our mental, as well as physical, health. Study after study shows that men and women who exercise are less likely than the sedentary to develop depression or anxiety. 

Additional research indicates that the reverse can be true, and people who feel depressed or anxious tend not to work out.But most of these studies examined connections between exercise and negative moods.  Fewer have delved into positive emotions and their links with physical activity, and fewer still have looked at the role of a strong sense of purpose and how it might influence whether we move, and the other way around.  This omission puzzled Ayse Yemiscigil, a postdoctoral research fellow with the Human Flourishing Program at Harvard University, who studies well-being.  “A sense of purpose is the feeling that you get from having goals and plans that give direction and meaning to life,” she says.  “It is about being engaged with life in productive ways.” This definition of purpose struck her as overlapping in resonant ways with many people’s motivations for exercise, she says. 

“Active people often talk about how exercise gives structure and meaning to their lives,” she says. “It provides goals and achievements.”In that case, she thought, physical activity plausibly could contribute to a sense of purpose and, likewise, a sense of purpose might influence how likely we are to exercise. But there was scant evidence to support those ideas. 

So, for the new study, which was published in April in the Journal of Behavioral Medicine, she and her colleague Ivo Vlaev, a professor of behavioral science at the University of Warwick in England, set out to find links, if any, between moving and meaning. They began by turning to the large and ongoing Health and Retirement Study, which gathers longitudinal data about the lives, attitudes and activities of thousands of American adults aged 50 or older.  It asks them at the start about their physical health, background, daily activities and mental health, including if they agree with statements like, “I have a sense of direction and purpose in life,” or “My daily activities often seem trivial and unimportant.” The study’s researchers then checked back after a few years to repeat the queries.

Then, Dr. Yemiscigil and Dr. Vlaev drew records for 14,159 of the participants.  To enlarge and enrich their sample, they also gathered comparable data for another 4,041 men and women enrolled in a different study that asked similar questions about people’s physical activities and sense of purpose. Finally, they collated and compared the results, determining, first, how much and how vigorously people moved, and also how strong their sense of purpose seemed to be.  The researchers then assessed how those disparate aspects of people’s lives seemed to be related to one another over the years, and they found clear intersections.  People who started off with active lives generally showed an increasing sense of purpose over the years, and those whose sense of purpose was sturdier in the beginning were the most physically active years later.  The associations were hardly outsize. 

Having a firm sense of purpose at one point in people’s lives was linked, later, with the equivalent of taking an extra weekly walk or two.  But the associations were consistent and remained statistically significant, even when the researchers controlled for people’s weight, income, education, overall mental health and other factors. “It was especially interesting to see these effects in older people,” Dr. Yemiscigil says, “since many older people report a decreasing sense of purpose in their lives, and they also typically have low rates of engagement in physical activity.”

This study was based, though, on people’s subjective estimates of their exercise and purposefulness, which could be unreliable. The findings are also associational, meaning they show links between having a sense of purpose at one point in your life and being active later, or vice versa, so do not prove one causes the other.

But Dr. Yemiscigil believes the associations are sturdy and rational. “People often report more self-efficacy” after they take up exercise, she says, which might prompt them to feel capable of setting new goals and developing a new or augmented purpose in life. And from the other side, “when you have goals and a sense of purpose, you probably want to be healthy and live long enough to fulfill them.” 

So, cue exercise, she says.

Monday, May 10, 2021

How to Participate in Challenging Athletic Events During the Pandemic


"At the outset (March and April) of the pandemic I was spending a good deal of time adapting and making adjustments to both my personal and professional life.  But in the past few weeks things have straightened out and a new normal has taken hold.  My wife has found ways to socialize without risk (which helps me not feel like I'm `abandoning' her while I work and train), my practice is completely virtual (i.e., telephone and video only, no in person work), and I've returned to steady and progressive training on the bike.  
As I've learned methods to minimize exposure to the virus I've reconsidered how and if I would participate in biking events.  Of course, most of these events have either been canceled or rescheduled to later in the year.  But there has been no notification as to whether the Natchez Trace 444 schedule has changed.  And I'm giving serious consideration to participating, still.  But my participation will have several caveats. 
If you're still up for crewing, and if I continue to plan on participating in it, here are a few considerations:
  • You, me, and another crew member would have to be tested for the Covid-19 virus immediately before the event.  At my expense.  
  • As well, we'd all have to have a robust antibody test. Again, at my expense.  
  • I think it responsible and prudent for each of us to get the Covid-19 and antibody tests after the event.  At my expense.
  • During the event we'd want to minimize proximate contact with other participants, their crew, vendors, gas station and store personnel.  
  • Wearing and using masks, hand sanitizers and handi-wipes would be essential.
Would you be willing to comply with these actions?"

Post-traumatic growth

Post-traumatic growth: the woman who learned to live a profoundly good life after loss

Rhian Mannings: ‘I know it’s made me a better person.’
Rhian Mannings: ‘I know it’s made me a better person.’ Photograph: Francesca Jones/The Guardian

After the deaths of her son and husband, Rhian Mannings emerged slowly from grief to start a charity and find love again. What does her experience tell us about how suffering can change us?

Tue 11 May 2021 01.00 EDT

In February 2012, Rhian was a happy, busy wife, mother of three and a PE teacher in Cardiff. She and her husband, Paul, had met on a blind date in their early 20s. “I knew as soon as we met that I wanted to be with him for ever.” Paul was handsome, kind and “sports-mad”; he was Rhian’s rock, she says. By the end of their honeymoon, she was pregnant, while their third child, George, celebrated his first birthday on Valentine’s Day 2012. He was a smiley baby, giggling, crawling everywhere, saying “hiya” all the time. “It was everything I’d ever wanted,” Rhian says.

A week after that birthday, Rhian and George were playing together after his bath when he had a seizure. An ambulance was called, but two hours after arriving at hospital, George died. Rhian says: “The nurse carried his body out of A&E and through the hospital corridors and found a closed children’s day unit, with cartoon characters all over the walls, cots with teddy bears in. That’s where we said goodbye to our little boy.” In her memory, she watches the scene from above, hovering over it as if in a dream. “That emotion of shock saves you in a way; it protects you. Because I didn’t feel anything.” They had left home with their youngest son; they returned without him. “George’s birthday cards were still up, and his presents were in a pile in the corner – but in the other corner was his vomit from when he fell ill, and bits of his clothing that had to be cut off him.”

In the days that followed, there were friends, family, cups of tea, memories, hope, devastation, silence and hugs. Five days after George’s death, Paul’s state of mind shifted. “He was saying it was his fault, that he had let me down as his wife, and the children,” says Rhian. He went for a drive, but hadn’t returned an hour later. There was a knock on the door. “I could see a police officer in uniform and … you know,” she says. The police officer told Rhian that Paul was dead. She says: “I can just remember putting my hand on the policeman and saying it was OK, because he was showing emotion, and then my whole body went. I wet myself, I started dribbling and being sick down myself. It went on for days and days, and I couldn’t lift my head off my chest.” It would be four months before she would learn that George had died from pneumonia and influenza A, which can be symptomless. Paul had taken his own life.

Shortly after the ninth anniversary of their deaths, she tells me: “It’s taken a long time to understand the person I am again, and to find a purpose” Now, she is Rhian Mannings MBE, the founder and CEO of 2 Wish Upon a Star, a charity that has supported more than 3,300 people in Wales affected by the sudden death of a child or young person. She recently won a Pride of Britain award, and last year married Craig, a man she met through the charity. She says: “I went through all this trauma. I was knocked off my feet to a place that I never want to experience again. I went right downhill, but then I came back up. I know it’s made me a different person, a better person.”

The shape of Rhian’s story, of growth out of trauma, is as old as humanity. It is a narrative that links the Bible, Nietzsche and women’s magazines, a trajectory we can trace in the lives of Hercules, Maya Angelou, Harry Potter, Doreen Lawrence, Nelson Mandela and Joe Biden. It is the story of hope: that we might grow through suffering, that we might emerge on the other side changed, “a better person”. We may well wonder, after a pandemic that has meant trauma, loss and illness to so many, can a better understanding of what happened to Rhian help us to grow from this experience, as she has?

In the 80s, Richard Tedeschi was an academic in the psychology department of the University of North Carolina when he and a colleague, Lawrence Calhoun, discovered a shared interest in the question of wisdom. They began interviewing people who might have accrued it through the survival of difficult experiences, including bereavement. Tedeschi and Calhoun coined the name post-traumatic growth to describe what they saw. Their first book was published in 1995, and, Tedeschi says: “We had one heck of a time trying to get anyone to publish it.” Twenty-five years on, Tedeschi is distinguished chair of the Boulder Crest Institute for Post-Traumatic Growth, and the measure he and Calhoun designed, the index of post-traumatic growth, is used all over the world.

Post-traumatic growth, Tedeschi explains, means “the positive changes that occur in the aftermath of a trauma as a result of the process of a struggle with these traumatic events”. Regardless of what shape the trauma takes, he says, whether it’s war, unemployment, bereavement, a car accident or a natural disaster, “the processes and outcomes are very similar”. He lists five areas of growth that people speak of in the aftermath of their suffering: increased personal strength; increased connection with and compassion towards others; greater appreciation and gratitude for their life, especially the small things; they might find a new mission in life; and they undergo an existential change, engaging with questions about the purpose, meaning and value of their life. Different studies have suggested that 58-83% of trauma survivors report a positive change in at least one area.

The process begins when the traumatised person is able to calm their anxiety and feel less overwhelmed by their emotions – and that often requires help. There follows a period of deliberate reflecting, putting things together, with the help of a person Tedeschi calls an “expert companion; expert at listening, but not necessarily a professional. It could be a therapist, a friend or family member, “someone you can be open with, who’s accepting, who isn’t going to give you simple answers or platitudes or just give you advice – someone who’s going to go on a journey with you”.

At some point in the first year after losing her son and husband, Rhian was told by her mother that she seemed to be “existing, but not living”. Rhian was desperate to give her children stability: she got out of bed every morning to dress them for nursery, and she bathed and fed them afterwards, and in between she would “dribble and retch all day until they came home”. She says: “I didn’t want to do anything or touch anything that reminded me of what I’d had,” she says. “I’ll never forget what my mum told me, because she was right – I needed to live.”

The start of that path towards life was also the start of 2 Wish Upon a Star. While accepting nothing could have been done to help George, Rhian believes Paul’s death could have been prevented. “Nobody told us that when a child dies, you’re going to blame yourself, you’re going to feel angry. We needed someone who understood to talk us through it, and that person never came. Someone should have been there to look after him and me,” she says. Rhian became determined “to put a bit of that right”.

She knew from her own experience that hospitals were not equipped to support the suddenly bereaved. Staff had to rush around to try to find something to make George’s handprints, and provide a place for them to sit in peace with their son. They had had no emotional support in the aftermath. Friends and relatives fundraised to build a family room in the hospital so that, Rhian says: “no other family has to make that walk – so that they’ve got somewhere there.” She built family rooms in other hospitals; introduced memory boxes for parents to keep locks of hair and other mementoes; trained staff; introduced counsellors; organised the provision of immediate support for bereaved families like hers. The charity grew, and made agreements with every police force and health board in Wales that when a child dies, the family is referred to them, with parental consent.

Then, in 2016, she burned out. “One day I just couldn’t get out of bed. I think my body said, you’ve had enough. And that’s when I started to see my psychotherapist,” she says. Once a week for one year, she talked to him about her self-hatred, the sense of guilt she couldn’t shake; the longing for Paul and George to be back with her, alive; the mask she had been wearing. She was diagnosed with PTSD. “He changed everything,” she says. “He made me accept what happened. Nothing I did would ever bring them back. And if I was going to stay on this earth, and I’ve never thought of anything else, then I had to make sure I led a good life. I couldn’t allow the boys’ deaths to mean nothing, I couldn’t let them be forgotten.”

It sounds as if this is when she began to grow. It echoes the distinction Tedeschi makes between someone who is experiencing post-traumatic growth, and someone who desperately wants to be happy again. “Post-traumatic growth is not happiness,” he says. “It often coexists with distress.” It is the opposite of being a Pollyanna; rather, it is an experience of loss and mourning so profoundly painful that it changes you for ever. “It’s hard-won wisdom,” Tedeschi says. “It’s knowing things viscerally or in your bones. It’s easy to say: ‘Appreciate life!’ or ‘Treat other people well!’, but doing that in the aftermath of a transformative trauma is a different way of understanding. It’s living it, having it in your gut.”

Eranda Jayawickreme, associate professor of psychology and director of the Growth Initiative Lab at Wake Forest University, North Carolina, says he and Tedeschi have sparred over the science of post-traumatic growth. It’s not that Jayawickreme doesn’t believe it is real; he saw it as a child in Sri Lanka, where he met many people affected by the civil war and insurrection. “Although my family were mostly insulated from a lot of what happened, I saw first-hand the possibility that people could grow, following the experience of adversity.” But, he says, during his research, “I realised that post-traumatic growth is such a compelling idea, we have a very strong motivation to believe in it. As a scientist, that gave me some pause.”

Among other issues, he questions how common post-traumatic growth is; he thinks the quality of some of the research “should make us sceptical of many of the findings”. This, he argues, is because of the way it is measured, through a subjective assessment by the individual. A person might wish they have grown, might feel they have grown – but this doesn’t necessarily mean, Jayawickreme argues, that they have. He explains: “We haven’t done a very good job of distinguishing post-traumatic growth as transformation and post-traumatic growth as a story that we tell to help us make sense of our experiences and reconcile ourselves to the implications of whatever we’ve been through.” While he and Tedeschi have been critical of each other’s work, Jayawickreme says: “I think he and his colleagues have done a great service by making this a popular area of study. My view is we now need to move on to the next step.”

Tedeschi’s definition of trauma is interesting. “We don’t define it in terms of a list of traumatic events,” he says. “Instead, we define it in terms of the impact of events on the core belief system that people have.” Most of us probably aren’t aware this core belief system exists, until it shatters, as Rhian’s did. There is a difference between resilience – where people bounce back from adversity, and go back to how things were before, which was impossible for Rhian – and post-traumatic growth, Tedeschi explains. “People who are resilient don’t grow in the aftermath of a certain event, because they don’t need to grow – they’re resilient to it.” I wonder if the pandemic will have been a trauma for us all, and he tells me: “It may not necessarily be a trauma for everyone. It depends on your core belief system.”

For some, post-traumatic growth may be possible, if they have the right support. But for others, Jayawickreme thinks, a narrative of growth out of the pandemic could be experienced as oppressive: if someone was already struggling to make ends meet before the pandemic, then lost a loved one, lost their job and was pushed into poverty, and now feels they are being told to grow, the notion of post-traumatic growth might well feel insulting. A person’s capacity for post-traumatic growth may depend on their personal experiences, resources, and structural advantages – or lack of them.

Tedeschi says that post-traumatic growth does not happen only with individuals, but also in systems, communities, nations. Can we see it in the birth of the NHS in 1948, out of the horror and losses of the second world war? This is how I see the birth of 2 Wish Upon a Star in 2012: as a fierce, mighty kind of care, rising up from pain a person should never have to face, but did. What growth might be possible for us, for our society, after Covid?

It was while she was having therapy that Rhian met her husband, Craig. She started exercising, spending more time with her children, taking pleasure in them. This year, sitting together at the table on Mother’s Day, she felt: “That’s all that matters.” When Rhian says it, it doesn’t sound like a cliche. “It took me a long time to sit at the table,” she says. “For years and years, I couldn’t because it reminded me of what I lost.” She finds joy, as Tedeschi described, in the small things. “Walking the dog and just feeling a bit of sun on my face. I love running in the rain because I feel I’m alive again. Paul and George will never experience any of this again, so everything I do, I want to savour and experience and appreciate.”

I ask Rhian what she makes of the idea of post-traumatic growth. She’s never heard of it before, but after she looks it up, she says: “My God, that’s me.” Rhian shows that to experience post-traumatic growth is to contain, to live, conflicting truths. “I still have bad days, but they’re different bad days. My heart is still broken, and in many places,” she says. “We have a really good life.”

Thursday, November 5, 2020

Why ‘healthy neurotics’ can thrive in stressful times

 Anxiety can be damaging, but harnessing your neuroticism could bring benefits, including some unexpected advantages in the current climate.


We all know the neurotic personality when we see it: think Monica from Friends, or George from Seinfeld. Neurotic people worry too much, and if they don’t have anything concrete to worry about, then they start worrying about not being worried. Perhaps you identify. 

On personality tests, participants rate their neuroticism with questions such as “I get irritated easily” and “I am much more anxious than most people” – and the more you agree with those statements, the more neurotic you are. These traits might make for an amusing sitcom character, but it hardly sounds like a recipe for health and happiness. If stress is truly bad for our health, as much research suggests, then you would expect neurotics to have shorter life expectancies. 

About two decades ago, however, Howard Friedman at University of California Riverside noticed that the evidence for this assumption was rather weak. “Some good studies showed neurotic people to be or become less healthy or die sooner,” he recalls, “while other good studies showed the opposite – that neurotic people tended to be or become healthier and live longer.” 

Given these mixed findings, Friedman began to wonder whether the personality trait could be something of a double-edged sword. While the anxiety by itself could be damaging in some circumstances, some people might use their worrying as motivation to improve their health. This would be especially true, Friedman suggested, for people with both high neuroticism and high conscientiousness (the tendency to be disciplined and organised), a personality type he described as the “healthy neurotic”. Imagine, for instance, that you have a health scare. A more laid-back personality might fail to respond to the risk, whereas the healthy neurotic would be more likely to get medical help. 

Untangling the various personality factors that might lead to different health outcomes, and explaining how they do it, is an extraordinarily difficult task. But various studies have outlined the benefits of being a healthy neurotic, including some unexpected advantages in the current pandemic. 

Inflamed feelings 

Let’s first consider an examination of chronic inflammation, by Nicholas Turiano at West Virginia University. Whenever we are ill or injured, the body sends out pro-inflammatory molecules. This leads to redness and swelling, but it helps to kill off microbes and to repair tissue – making inflammation an essential weapon in our bodies’ defences. Unfortunately, various behaviours – such as smoking, drinking, overeating and physical inactivity – can create lingering long-term inflammation. Over time, this can damage our tissues, leading to arthritis, diabetes, cancer, heart disease and perhaps even Alzheimer’s. Measuring the levels of the key pro-inflammatory molecules therefore provides a snapshot of someone’s current health and their risk of illness in the future. 

To discover whether someone’s personality might influence their risk of chronic inflammation, Turiano examined a survey of more than 1,000 middle-aged participants who had undergone regular health checks. Supporting the theory of the “healthy neurotic”, Turiano found that people with the combination of higher conscientiousness and higher neuroticism had reduced levels of inflammation, faring better than people who had scored highly on just one of the traits. 

Like Friedman, Turiano proposed that the reason for these differences lay in the ways they responded to their anxieties. Healthy neurotics tend to have a lower body mass index, for example, perhaps because they are more conscious of the health risks of obesity, and so make more effort to maintain a healthy weight.

It's possible that a dose of neuroticism may make you more likely to look after your health

Along these lines, Mirjam Stieger, a psychologist at Brandeis University near Boston, has recently shown that healthy neurotics are more likely to stick to a new exercise regime. The subjects were given a FitBit tracker and encouraged to increase the number of steps they took every day, using a process known as “implementation intentions” (in which you make a concrete plan of when and where you will exercise). As expected, people with high conscientiousness tended to show greater improvements than people who were low in conscientiousness. But people who were high in both conscientiousness and neuroticism performed better still. “Healthy neurotics may be better able to channel their health concerns into positive behaviours,” she concludes. 

A recent meta-analysis of 15 studies examining personality and health behaviours across the US, UK, Australia and Germany bolster this argument. The researchers found that people with high neuroticism and conscientiousness are less likely to smoke and more likely to take regular exercise

Constructive coping 

The events of 2020 have, of course, turned many of our assumptions on their head – and you may wonder if the additional stresses of the pandemic would overwhelm any of the benefits that might come from neuroticism. 

Yet the latest research suggests that some neurotic personalities have coped surprisingly well with the uncertainty of Covid-19. The study in question looked at American employees’ sense of powerlessness in the last two weeks of March this year – just after the US government had declared a state of national emergency. As you would expect, everyone started to feel helpless at the beginning of this period, but the researchers found that people scoring high on neuroticism tended to recover the feeling of autonomy and control more quickly than those who had more laidback personalities. Although this particular survey did not also examine conscientiousness, the authors argue that it fits with the general concept of healthy neuroticism, showing how a heightened vigilance to new threats could sometimes lead to constructive coping.

 Given the previous research, it’s possible that healthy neurotics will also be less likely to catch the virus itself – as their naturally anxious personalities will lead them to take more precautions, such as handwashing, mask wearing and social distancing.

Neuroticism may make you more likely to take suitable Covid-19 precautions

Needless to say, Friedman welcomes these findings. “The studies clearly show that although depressive rumination and chronic hostility are unhealthy, the vigilance and worrying concern of healthy neuroticism – paired in the right circumstances with the prudence and responsibility of being conscientious – can produce very healthy patterns.” 

Harnessing your neuroticism 

The long-term benefits of neuroticism remain a matter of debate, however. Sara Weston, an assistant professor at the University of Oregon, is among the researchers who have shown that healthy neuroticism can reduce smoking, yet her analyses have found no evidence that healthy neurotics live longer than the average person. “People who are high in both neuroticism and conscientiousness may engage in healthier habits, but it doesn't seem like this has strong downstream consequences,” she says. The physiological effects of the stress itself – such as increased strain on the heart – could counteract the positive behavioural changes, she suspects, meaning that you see no overall increase in longevity. 

Even so, she hopes that an understanding of healthy neuroticism may still help to suggest ways to personalise interventions so that people can capitalise on their existing strengths. “You could harness those behavioural tendencies and use them as a way to push people to do things that would have an impact on their health.” 

If you are high in neuroticism but lower in conscientiousness, you might try to boost your self-discipline to make sure that you act on your anxieties. Stieger is currently testing this possibility with an app that educates people about the benefits of conscientiousness and guides them to make specific plans to increase their physical activity. (As we wait for those results, you could look to BBC Worklife’s archive for some immediate evidence-based ways to increase perseverance and discipline.) 

Those of us with a neurotic personality might also reconsider the ways we frame our worries. A swathe of recent research has shown that our attitudes to anxiety often determine how it affects our mental and physical health. If we believe anxiety to be damaging, then we tend to take longer to recover from stressful events and suffer more long-term consequences from the experience; if we see anxiety as a source of motivation and energy, however, we tend to perform better and recover more quickly after the stress has passed. Although the mechanisms are still being explored, it seems that this more positive view of anxiety stops us from descending into counter-productive rumination about our worries, and helps to bolster our confidence in our ability to cope. One study, which tracked a cohort of German doctors and teachers, found that this attitude completely buffered the detrimental effects of heightened anxiety over the course of a year. With further research, it may turn out that the shift to healthy neuroticism can be achieved through a simple change in mindset. 

Friedman certainly thinks it’s time to take a more nuanced understanding of our personalities and our feelings. “The current zeitgeist often equates the anxiety and moodiness aspects of neuroticism with ‘stress’, and sees this ‘stress’ as a cause of disease, even in light of considerable documentation that this is a dangerous over-simplification,” he argues. “Worrying can be OK, especially in situations like a pandemic.” In this new age of anxiety, there may be no better time to embrace the benefits of our fretful minds. 

David Robson is the author of The Intelligence Trap: Why Smart People Do Dumb Things (WW Norton/Hodder & Stoughton). He is @d_a_robson on Twitter.